In addition, the mechanism of hydrazine electrochemical oxidation

In addition, the mechanism of hydrazine electrochemical oxidation catalyzed by Pd-NPs/PAni/Ti was investigated. (c) 2011 Wiley Periodicals, Inc. J Appl Polym Sci, 2011″
“Objectives: To determine device-associated healthcare-associated infection (DA-HAI) rates and the microorganism profile in 398 intensive care units (ICUs) of 70 hospitals in Shanghai, China.

Methods: An open-label, prospective, cohort, active DA-HAI surveillance study was conducted on patients admitted to 398 tertiary-care ICUs in China from September 2004 to December 2009, implementing the methodology developed by the International Nosocomial Infection Control Consortium (INICC). The data were collected in the participating ICUs, and uploaded

and analyzed at the INICC headquarters on proprietary software. DA-HAI rates were registered by applying the definitions of the US Centers for Disease Avapritinib manufacturer Control and Prevention (CDC) National Healthcare Safety Network (NHSN). We analyzed the rates of DAI-HAI, ventilator-associated pneumonia (VAP), central buy Y-27632 line-associated bloodstream infection (CLABSI), and catheter-associated urinary tract

infection (CAUTI), and their microorganism profiles.

Results: During the 5 years and 4 months of the study, 391 527 patients hospitalized in an ICU for an aggregate of 3 245 244 days, acquired 20 866 DA-HAIs, an overall rate of 5.3% (95% confidence interval (CI) 5.3-5.4) and 6.4 (95% CI 6.3-6.5) infections per 1000 ICU-days. VAP posed the greatest risk (20.8 per 1000 ventilator-days, 95% CI 20.4-21.1), followed by CAUTI (6.4 per 1000 catheter-days, 95% CI 6.3-6.6) and CLABSI (3.1 per 1000 catheter-days, 95% CI 3.0-3.2). The most common isolated microorganism was Acinetobacter baumannii (19.1%), followed by Pseudomonas aeruginosa (17.2%), Klebsiella pneumoniae (11.9%), and Staphylococcus aureus (11.9%).

Conclusions: DA-HAIs in the ICUs of Shanghai pose a far greater threat to patient safety than in ICUs in the USA. This is particularly the case

for the VAP rate, which is much higher than the rates found in Bromosporine developed countries. Active infection control programs that carry out infection surveillance and implement prevention guidelines can improve patient safety and must become a priority. (C) 2011 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.”
“Little is known about the nature of spine surgery training received by European neurosurgical trainees during their residency and the level of competence they acquire in dealing with spinal disorders.

A three-part questionnaire entailing 32 questions was devised and distributed to the neurosurgical trainees attending the EANS (European Association of Neurosurgical Societies) training courses of 2004.

Of 126 questionnaires, 32% were returned. The majority of trainees responding to the questionnaire were in their final (6(th)) year of training or had completed their training (60.3% of total).

Fe3O4 nanoparticles were efficiently incorporated into the murine

Fe3O4 nanoparticles were efficiently incorporated into the murine macrophage cells (RAW264.7) without visible cytotoxicity. Cell labeling efficiency was found to be over 90% as measured by magnetically activated cell sorting and physical property measurement system. Therefore, such Fe3O4 nanoparticles could provide a useful magnetic cell labeling tool for macrophage cells using their phagocytic/endocytic activity and further apply to the other relevant biomedical applications.

(C) 2011 American Institute of Physics. [doi: 10.1063/1.3563073]“
“The global incidence of nonalcoholic steatohepatitis (NASH) is increasing and current mammalian models of NASH are imperfect. We have developed a NASH model in the ricefish medaka (Oryzias latipes), which is based on feeding the fish a high-fat diet (HFD). Medaka that are fed a HFD (HFD-medaka) exhibited hyperlipidemia and hyperglycemia, Ganetespib in vivo and histological examination of the liver revealed ballooning degeneration. The expression of lipogenic genes (SREBP-1c, FAS and ACC1) was increased, whereas the expression of lipolytic genes (PPARA and CPT1) was decreased.

With respect to liver fatty acid composition, the concentrations of n-3 polyunsaturated fatty acids (PUFAs) and n-6 PUFAs had declined and the n-3: n-6 ratio was reduced. Treatment selleck chemicals of HFD-medaka with the n-3 PUFA eicosapentaenoic acid (EPA) mitigated disease, as judged by the restoration of normal liver fatty acid composition and normal expression levels of lipogenic and lipolytic genes. Moreover, medaka that were fed a diet deficient in n-3 PUFAs developed NASH features. Thus, NASH can be induced in medaka by a HFD, and the proportion of n-3 PUFAs in the liver influences the progress of NASH pathology in these fish. Our model should prove helpful for the dissection of the causes of

human NASH and for the design of new and effective therapies.”
“Purpose: The purpose of the study was to characterize differences in donor and recipient relationships between African American (AA) and Caucasian living kidney donors.

Methods: Data from all successful living kidney donors at a single institution between 1991 and 2009 were reviewed. Relationships Cl-amidine mouse between donor and recipient were categorized and between-group comparisons performed.

Results: The study sample consisted of 73 (18%) AA and 324 Caucasian living kidney donors. The distribution of donor-recipient relationships differed significantly between AA and Caucasians. AA donors were more likely to be related to the recipient (88% vs. 74%, p = 0.007) than Caucasians. AA donors were more likely to participate in child to parent donation and were less likely to participate in parent to child donation or to donate to unrelated individuals. Sibling and spousal donations were similar in both groups. Caucasian donors were more likely to be unrelated to the recipient than AA donors.

6 years,

twenty-eight patients were seen untreated at ske

6 years,

twenty-eight patients were seen untreated at skeletal maturity, and four patients had no follow-up.

Results: The unsegmented bar occurred at all levels; the mean extent was three vertebrae (range, two BIRB 796 concentration to eight vertebrae). Before the age of ten years, patients had a mean rate of scoliosis progression without treatment for all regions of the spine of 2 degrees to 3 degrees per year. By the age of ten years, seventy-three patients who had been seen untreated or prior to treatment had a mean scoliosis of 50 degrees (range, 18 degrees to 100 degrees). After the age of ten years, these patients had an increase in the mean rate of scoliosis progression, but this rate varied per year depending on the affected region of the spine: 7 degrees for the thoracolumbar curve, 5 degrees for the midthoracic curve, and 4 degrees for the upper thoracic curve. Spine surgery was performed on seventy-four patients who had a mean age of 12.2 years and a mean scoliosis of 78 degrees for thoracolumbar curves, 66 degrees for midthoracic curves, and 54 degrees for upper thoracic curves. Of the patients with midthoracic congenital scoliosis, 24%

developed a lower structural compensatory curve, which became larger and more deforming than the congenital curve, 22% had congenital rib fusions, and 16% had occult intraspinal anomalies.

Conclusions: Prognosis depends on growth imbalance at the site of the unsegmented bar as well as the location and extent of the bar, age at diagnosis, and spinal growth remaining.”
“A lattice relaxation process and a crystallographic tilt in GaP Selleckchem Givinostat layers grown on misoriented Si(001) substrates by metalorganic vapor phase epitaxy were investigated. Strained pseudomorphic GaP layers without defects on Si were successfully achieved by the optimization of growth conditions. Below critical thickness, the strained GaP layers were tilted in the misoriented direction of the Si substrates and triclinically distorted. Above critical thickness, the residual strain in the GaP layers was progressively CHIR-99021 order relaxed with increased

thickness of the GaP layers by forming 60 degrees misfit dislocations propagating to the two orthogonal << 110 >> directions at the heterointerface. X-ray diffuse scattering around the symmetrical GaP(004) diffraction was observed after introducing misfit dislocations. Diffuse scattering became dominant with an increase in the density of the misfit dislocations and resulted in a broadening of the full width at half maximum of the x-ray rocking curves. The GaP layers that were relaxed with highly dense misfit dislocations were tilted opposite of the misoriented direction due to the imbalance nucleation of the misfit dislocations on each 111 glide plane.”
“High-resolution sonography is a rapidly evolving technique that is gaining an increasing success in the assessment of crystalline arthropathies.

87). The AQ20S showed a high correlation with the SGRQ in both as

87). The AQ20S showed a high correlation with the SGRQ in both asthma and COPD (r (s) > 0.75; P < 0.001), as well as with the AQLQ (r (s) = -0.72, P < 0.001) in asthma and with the CRQ (r (s) = -0.59; P < 0.001) in COPD. The AQ20S showed significant correlation with clinical and functional variables, similar to the SGRQ and the AQLQ in asthmatics, but Elacridar price weaker than the SGRQ in COPD patients. Changes in AQ20S scores correlated quite well with changes in other HRQoL questionnaires, both in asthma and COPD.

The AQ20S showed psychometric properties similar to the original questionnaire. It was equally useful compared with the SGRQ and

the AQLQ in asthma patients and slightly less useful than the SGRQ in COPD patients. Considering its simplicity, the AQ20S may be an alternative to more complex traditional questionnaires.”
“Introduction Chronic pain is a public health concern, and in the last decade, there has been a dramatic increase in the use and abuse of prescription opioids for chronic non-cancer pain. Methods We present an overview of a five-component model of pain management implemented at the University of Washington Division of Pain Medicine designed to facilitate recent state guidelines to reduce the risks associated with long-term use of prescription

opioids. Results Central to the Navitoclax chemical structure model described are guidelines for best clinical practice, a collaborative care approach, telehealth solutions, comprehensive prescription-monitoring, and measurement-based care. Discussion The model presented is a patient-centered, efficient, and cost-effective approach to the management of chronic

pain.”
“A large body of information proves that Orexin-A is present in the pancreatic endocrine cells of humans and laboratory animals; more detailed studies identify Orexin-A-immunopositive cells as beta cells. Because no data have been reported on the pancreas of domestic animals, we investigated the presence and the distribution of cells containing Orexin-A in the pancreas of cattle, sheep and pigs by means of immunohistochemical techniques.

Using a polyclonal antibody against Orexin-A, the immunopositive reaction was identified in the cytoplasm of many insular cells in the three species studied.

Double immunohistochemical staining, using a polyclonal anti-insulin Birinapant antibody, showed that Orexin-A is co-expressed with insulin.

Our results, besides showing the presence of Orexin-A in the endocrine pancreas of domestic animals, together with data present in the literature, could contribute to the understanding of complex mechanisms regulating the functionality of the endocrine pancreas in domestic animals. (C) 2010 Elsevier Ltd. All rights reserved.”
“Objectives. Animal-assisted therapy using dogs trained to be calm and provide comfort to strangers has been used as a complementary therapy for a range of medical conditions.


“Five compounds have been isolated from the leaves of Vite


“Five compounds have been isolated from the leaves of Vitex negundo Linn (Verbenacea) and their structures established by spectral analysis. Compound 1 has been identified and characterised as a new iridoid with a novel structure which has never before been reported in literature from Vitex or any other source. Its structure has

been established as 1,4a,5,7a-tetrahydro-1–D-glucosyl-7-(3′,4′-dihydroxybenzoyloxymethyl)-5-ketocyclopenta[c]pyran-4-carboxylic acid. Other compounds, 2, 3, 4 and 5, have been identified GNS-1480 as luteolin-7-O–D glucoside, nishindaside, negundoside, and agnuside, respectively. Compound 2, a flavone-O-glycoside, is being reported from this plant for the first time, and compounds 3, 4 and 5 are structurally known iridoids.”
“Standard follow up for bone recurrence has not yet been established for gastric cancer after surgical resection. The aim of this study was to investigate the incidence of and related risk factors for bone recurrence after surgical resection of

gastric cancer.

A cohort of 3035 gastric cancer patients after curative resection was reviewed. We analyzed the patients who had bone scintigraphy before the surgery as well as during the follow-up period. The incidence of and the risk factors for bone recurrence after surgical resection of gastric cancer were investigated.

In a total of 1683 patients

analyzed, bone recurrence was detected in 30 patients www.selleckchem.com/products/tpx-0005.html (1.8 %). The incidence of bone recurrence was significantly higher in advanced gastric cancers than in early lesions (3.5 vs. 0.4 %, p < 0.01). The most common recurrence site was the spine, followed by pelvic bone and rib. Most patients had multiple bone metastases. The median time for recurrence was 28 months (range 4-111) from the surgery. In univariate analysis, the recurrence rate was higher in the tumors with large size, undifferentiated pathology, location in the body, and advanced stage. In multivariate analysis, lymph node metastasis (N2/N3 vs. N0/N0I) was the most predictable risk factor for bone recurrence [hazard ratio [HR] 1.44 (95% Selleck MAPK 抑制剂 confidence interval [CI] 1.217-1.694)] and depth of invasion (T2-4 vs. T1) was also independently associated with bone recurrence.

The incidence of bone recurrence was low after curative surgery in patients with gastric cancer. Intensive follow up with bone scintigraphy seems to be unnecessary in these patients.”
“Zero-valent palladium nanoparticles stabilized by arabinogalactan polysaccharide matrix were successfully used for the first time as phosphine-free catalyst in the cross-coupling of terminal alkynes with aryl and hetaryl halides.”
“Two new guaianolides artemanomalides A and B were isolated from the aerial parts of Artemisia anomala S. Moore.


“Object. The safety of spinal fusion has been poorly studi


“Object. The safety of spinal fusion has been poorly studied in children with surgically corrected congenital cardiac malformations (CCMs). The objective of this study

was to evaluate the safety of spinal fusion in patients with CCMs following cardiac surgery.

Methods. A retrospective study was conducted on 32 patients with scoliosis who received surgical treatment for their CCMs (CCM group). Sixty-four age- and sex-matched patients with scoliosis and normal hearts who received BMS-754807 Protein Tyrosine Kinase inhibitor spinal fusion served as the control group. These 2 groups were compared for demographic distribution, blood loss, transfusion requirements, and incidence of postoperative complications.

Results. The ages, curve pattern distributions, and number of levels fused were similar between the 2 groups before spinal fusion. Overall, a total of

7 patients in the CCM group (21.9%) and 5 (7.8%) in the control group had documented postoperative complications. The perioperative allogenic blood transfusion rate and mean red blood cell transfusion requirement in the CCM group were significantly higher than those found in patients in the control group (68.7% vs 28.1%, respectively, p = 0.000; and 2.68 +/- 2.76 units/patient vs 0.76 +/- 1.07 units/patient, respectively, p = 0.011). In the CCM group, a preoperative major curve magnitude >= 80 degrees was the most accurate indicator of an increased risk for a major complication (p = 0.019), whereas no statistically significant correlation

was noted between postoperative complications and age, type of congenital heart disease, operative duration, learn more and estimated blood loss during the WZB117 manufacturer operation and transfusion.

Conclusions. Spinal fusion subsequent to prior cardiac surgery is relatively safe and effective in correcting the spinal deformity for patients with scoliosis and surgically corrected CCMs. A preoperative major curve magnitude >= 80 degrees may be a risk factor in predicting postoperative complications in scoliotic patients with surgically corrected CCMs.”
“Tumor-associated antigen MX35, which is overexpressed in 70-90% of epithelial ovarian cancers, has been recently identified as phosphate transporter NaPi2b. This finding has raised significant interest in understanding NaPi2b function under physiological conditions and its deregulation in human pathologies, such as cancer. As a member of the sodium-dependent phosphate transporter family, NaPi2b is primarily involved in the maintenance of phosphate homeostasis in the human body. The role of NaPi2b in oncogenic transformation and malignant growth is not well understood. To date, several monoclonal antibodies specific to NaPi2b have been reported. However, available monoclonal antibodies are not very efficient in recognizing endogenous NaPi2b under reducing conditions. In addition, these antibodies could not recognize the mutant form of transporter (NaPi2b-T330V).

With the dramatic growth in contrast-enhanced imaging services wo

With the dramatic growth in contrast-enhanced imaging services worldwide, including procedures involving exposure to iodinated CM, efforts to reduce the occurrence of CIN have received considerable attention in recent years. To date, these efforts have met with little success since the 12% prevalence of CIN today remains unchanged from 2 decades ago.

Methods: We conducted a systematic Selleck VX-770 literature review of the most recent evidence available from published reports of contemporary ( 2000-2008) prospective, randomized, controlled trials that have investigated CIN either by comparing

CM or by comparing preventive strategies. The objective was to critically review find more the findings in light of several aspects of study design and then to establish a set of parameters for consideration in the planning of future CIN trials so as to optimize the strength of evidence obtained.

Results: Whether future CIN trials are investigating comparative CM nephrotoxicity or dealing with prophylactic strategies for risk reduction, the complexities that

must be addressed include a standardized definition of CIN, appropriate timing of SCr measurements with timing standardized for all subjects in a given study population, awareness of study population risk profile, hydration protocols, and pharmacological prophylactic strategies.

Conclusions:

Large, well-designed trials ( ideally with hard clinical outcome measures) that consider all the complexities involved in CIN and its prevention are needed before the clinical community has the evidence-based direction required for optimized patient care.”
“Purpose of reviewTo show that skin symptoms help KU-60019 research buy in the recognition of primary immunodeficiencies (PIDs). To analyze whether recent molecular data help in understanding genotype/phenotype relations.Recent findingsErythroderma in Omenn syndrome may be caused by either mutations in genes associated with severe combined immunodeficiency (SCID) in which the generation of some T cells is possible, which results in potentially autoreactive lymphoid clones, or by selective proliferation of revertant CD8(+) T cells in the skin due to clonal expansion in response to infections or autoantigens.The newborn eczematous eruption, which occurs mainly in the signal-transducer-and-activator-of-transcription-3 (STAT3) variant, helps to differentiate STAT3 from Dedicator of Cytokinesis 8-related Hyper-IgE-syndrome (HIES).

(c) 2010 Wiley Periodicals, Inc. J Appl Polym Sci 116: 2496-2503,

(c) 2010 Wiley Periodicals, Inc. J Appl Polym Sci 116: 2496-2503, 2010″
“We use “”edge mode”" ferromagnetic resonance to probe the magnetic properties of oxidized Ni80Fe20 (Py) nanostripe edges. The oxidation is carried out using either oxygen plasma or thermal annealing in an oxygen ambient. We find that for both treatments the edge saturation field decreases systematically with increasing GDC-0994 oxidation due to reduced magnetization near the edges. However, the change of effective out-of-plane anisotropy field shows opposite trends for these two

oxidation methods. Micromagnetic simulations suggest that thermally annealed samples may have an additional reduction in the bulk magnetization, possibly due to a compositional change in Py stripes. The two distinct oxidation profiles also result in different changes in resonance linewidth; we find little damping change for plasma treatment but an enhanced effective damping for thermal annealing. (C) 2010 American Institute of Physics. [doi: 10.1063/1.3393966]“
“Systemic lupus erythematosus (SLE) is a multisystem, autoimmune connective tissue disorder. Neuropsychiatric SLE (NPSLE) has varied clinical and radiological manifestations. Clinical manifestations range from subtle abnormalities of neurocognitive functions and mood changes to overt psychiatric or neurological manifestations such as seizures,

stroke, and psychosis. Magnetic resonance imaging (MRI) may show various types of abnormalities. Cerebral white matter lesions are most common (60-86%). Here, we are discussing HKI-272 nmr a young female who presented with alteration of sensorium and right-sided hemiparesis, and MRI of the brain showed extensive involvement of brainstem in the form of possible demyelination.”
“Aim: A meta-analysis was performed to evaluate the possible predictors of the positive PALN(para-aortic lymph nodes) for identifing

specific patients who are at high risk of PALN metastases and for whom super-extended lymphadenectomy or pre-operative DCS therapy could be recommended.

Methods: Five databases (PUBMED, EMBASE, the Cochrane Library and the China Biological Medicine Database, CNKI) were searched that finally identified 11 candidate studies. Original data were abstracted from each study check details and used to calculate odds ratios. The random effects or fixed-effect model was used to combine odds ratios to determine the strength of the associations.

Results: In this study, we eventually found 6 risk factors in the clinicopathologic characteristics including tumour located in the upper third(P < 0.01, OR = 2.19), tumour size exceeding 5 cm(P < 0.01, OR = 3.42), tumour infiltrating deeper than T2 (P < 0.01, OR = 2.07), tumour in the stage N2 and N3(P < 0.01, OR = 12.03), and tumour regarded as the poorly differentiated type by the histologic classification (P < 0.01, OR = 2.

From each calf, blood samples were collected before

and a

From each calf, blood samples were collected before

and approximately 24 hours after treatment. Serum IgG and total protein (TP) concentrations were quantified with standard methods, and the apparent efficiency of IgG absorption was calculated.

Results-At 24 hours after treatment, mean serum TP and IgG concentrations were significantly lower for calves fed pooled MC (TP, 4.77 g/dL; IgG, 750 g/L), compared with those for calves fed the LDCR (TP, 5.50 g/dL; IgG, 15.15 g/L). Calves fed the LDCR were 95% less likely to develop FPT (OR, 0.05; 95% confidence interval, 0.03 to 0.08) than were calves fed pooled MC. However, buy LCL161 the mean IgG concentration in the pooled MC fed during the study (21.1 g/L) was substantially lower than that (64.3 g/L) determined for representative samples of pooled MC from other southwestern

US dairies during a national survey.

Conclusions and Clinical Relevance-Results indicated that, on this particular dairy, calves fed an LDCR were at less Y-27632 datasheet risk of developing FPT than were calves fed pooled MC. The LDCR evaluated was a viable alternative for the prevention of FPT in calves.”
“in this study, in order to isolate inulinase overproducers from the marine yeast Pichia guilliermondii, its cells were treated by using UV light and LiCl. The mutant M-30 with enhanced inulinase production was obtained and was found to be stable after cultivation for 20 generations. Response surface methodology (RSM) was used to optimize the medium compositions and cultivation conditions for inulinase production by the mutant M-30 in liquid fermentation. Inulin, yeast extract, NaCl, temperature, pH for maximum inulinase production by the mutant M-30

were found to be 20.0g/l. 5.0 g/l. 20.0 g/l. 28 degrees C P-gp inhibitor and 6.5, respectively. Under the optimized conditions, 127.7 U/ml of inulinase activity was reached in the liquid culture of the mutant M-30 whereas the predicted maximum inulinase activity of 129.8 U/ml was derived from RSM regression. Under the same conditions, its parent strain only produced 48.1 U/ml of inulinase activity. This is the highest inulinase activity produced by the yeast strains reported so far. We also found that inulin could be actively converted into monosaccharides by the crude inulinase. (C) 2008 Elsevier B.V. All rights reserved.”
“High-performance liquid chromatography coupled with an ultraviolet detector was used to quantitatively determine the amount of caffeoylquinic acid, arctium lappa glycoside, aurantiamarin and forsythin present in five solvent extracts (water, 30% ethanol, 50% ethanol, 70% ethanol and 95% ethanol) of Yinqiaosan (YQS). The calibration curves of the four components were linear (r(2)>0.998) over the concentration range of 0.9-151.5 mu g/mL. This method showed good repeatability with relative standard deviations of less than 2.9% and mean recoveries of 91.3-100.5%. We established the relative amounts of each of the four main ingredients in YQS for all five solvent extracts.

The quality of the included studies was assessed by a modified qu

The quality of the included studies was assessed by a modified quality assessment tool that had been previously designed for observational studies. The effects of studies were combined with the study quality score using a best-evidence synthesis model.

Thirty-six observational studies involving 2,439 patients with

SSI after spinal CRM1 inhibitor surgery were identified. The included studies covered a wide range of indications and surgical procedures. These articles were published between 1998 and 2012. According to the quality assessment criteria for included studies, 15 studies were deemed to be high-quality studies, 5 were moderate-quality studies, and 16 were low-quality studies. A total of 46 independent factors were evaluated for risk of SSI. There was strong evidence for six factors, including obesity/BMI, longer operation times, diabetes, smoking, history of previous SSI and type of surgical procedure. We also identified 8 moderate-evidence, 31 limited-evidence and 1 conflicting-evidence factors.

Although there is no conclusive evidence for why postoperative

SSI occurs, these data provide evidence to guide clinicians in admitting patients who will learn more have spinal operations and to choose an optimal prophylactic strategy. Further research is still required to evaluate the effects of these above risk factors.”
“Background: Little is known about geographic differences in health status among patients with chronic obstructive pulmonary disease (COPD). Objectives: The aim of this study was to examine regional variations in self-reported health status of COPD patients at 7 Veterans Affairs clinics. Methods: The Ambulatory Care Quality Improvement Project was a multicenter,

randomized trial conducted from 1997 to 2000 that evaluated a quality improvement intervention in the primary care setting. Four thousand and nine participants with COPD (age 6 45 years) completed the Seattle Obstructive Lung Disease GW2580 supplier Questionnaire (SOLDQ) and 2,991 also completed the Medical Outcomes Study 36-item short form (SF-36). The unadjusted maximal difference in health status scores is reported as the ratio of the highest and lowest site prevalence. We report the maximal site difference in mean health status scores after adjusting for demographics, comorbidities, utilization, medication use and clinic factors. Results: Subjects were predominantly older (66.5 +/- 9.2 years) Caucasian (83.2%) men (97.9%). After adjustment, the maximal site difference for each health status score was significant (p < 0.01) but larger for the SOLDQ (physical 11.2, emotional 9.7, coping skills 7.6) than for the SF-36 (physical component summary 4.7, mental component summary 2.6). Most of the health status variation was explained by individual or clinic level factors, not clinic site.